Nano-based Strategies for Leishmaniasis: Overcoming Drug Resistance, Toxicity, and Delivery Barriers to Transform Clinical Management and Accelerate Translation
Megha Garg, Neha Jain, Chirag Jain, Shreya Kaul, Manisha Pandey, Upendra NagaichIntroduction:
Leishmaniasis, caused by Leishmania protozoa, is a serious health issue in the endemic areas. Conventional therapies are common but are plagued with drug resistance, toxicity, poor drug availability, and minimal therapeutic outcomes. Recent developments in nanotechnology, along with patent-protected formulations, present new therapeutic prospects by enhancing the solubility, bio-distribution, and targeted delivery of drugs, thus eliminating most of the undesirable effects that traditional treatments have.
Methods:
The literature search and selection process was conducted in a structured and transparent manner, following a PRISMA-inspired approach. Literature search was conducted across major scientific databases, such as PubMed, Springer, and ScienceDirect, with key terms that included: nanoparticles in leishmaniasis, nanocarriers of leishmaniasis management, and nanoformulations of leishmaniasis. Only original in vivo studies published in the past decade were considered, and reviews, commentaries, and non-efficacy studies were excluded.
Results:
The primary search produced 1,432 articles, which were narrowed down to 1,150 through elimination of duplicates. A total of 32 studies were found after the screening and application of inclusion/ exclusion criteria. Together, these studies concluded that nano-based systems enhanced the drug solubility, stability, and targeted macrophage delivery, as well as reducing systemic toxicity in comparison to conventional treatment. The majority of formulations had increased parasite clearance in vivo, extended drug circulation, and a lower frequency.
Discussion:
Research studies demonstrated that different nanoparticle systems, such as liposomes, polymeric, lipid-based, vesicular-based, and metallic nanoparticles, exhibited controlled release, prolonged blood circulation, and mechanisms of avoiding parasite resistance mechanisms. Such encouraging results have not yet translated into practice. Regulatory uncertainties, high cost, and largescale reproducibility are major barriers. However, nano-based strategies coupled with artificial intelligence- driven design have the potential to accelerate clinical translation in endemic regions.
Conclusion:
Nanotechnology is a new paradigm for the management of leishmaniasis. The development of multidisciplinary collaboration and concentrated research is required to enhance clinical acceptance, cost reduction, and accessibility in endemic areas.